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(282 results for Community Reinforcement Plus Vouchers)

Community Reinforcement Plus Vouchers

The goal of a community-reinforcement approach (CRA) for alcoholism is to achieve abstinence by eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. The underlying philosophy is quite simple – in order to overcome alcohol problems, it is important to rearrange the person’s life so abstinence is more rewarding than drinking. CRA, unlike negative approaches, uses positive incentives to help a client stop drinking instead of punishing the client for failing to stop drinking. In CRA, the client, therapist and significant others work collaboratively to change the alcoholic’s lifestyle through enacting social support systems and healthier activities.

Elements Integral to CRA

Building the client’s motivation to quit drinking: Initially, this process involves identification of positive reinforcements (e.g. praise and shared pleasant events) that might serve as effective incentives for the client to change his or her behavior. The therapist and client create a list of current negative consequences of drinking (e.g. marital or work problems), however, the client is encouraged to devise his or her own patterns of positive change.

Helping the client initiate sobriety: Many clients are reluctant to commit to immediate or complete sobriety. Sobriety sampling uses various counseling strategies to negotiate intermediate goals, for example, a one-month period of sobriety. Research shows allowing a client to set goals regarding a trial period of abstinence results in better outcomes than when a client is given a firm order of abstinence.

Analyzing drinking patterns: This helps identify situations in which drinking is most likely to occur (high-risk situations) as well as past positive consequences of alcohol consumption that potentially reinforced drinking. This step is helpful in determining specific treatment components or modules to tackle a client’s drinking patterns.

Increasing positive reinforcement: Alcoholics often limit their activities and become social loners. An important component of recovery is to reverse the isolation process by spending time with nondrinkers and increasing enjoyable non-drinking-related activities. If a client cannot make a decision what activities to choose, activity sampling encourages trying different activities, or reengaging in activities he or she once found enjoyable.

Learning new coping behaviors: Clients are not told how to change their behaviors. Instead, they practice new coping skills during counseling sessions, especially those involving interpersonal communication.

Involving significant others in the recovery process: Loved ones are coached on how to identify social situations that spark drinking behavior and support behavioral changes in their partners. Moreover, loved ones are taught how to avoid inadvertent reinforcement of drinking (also known as enabling) and increase positive reinforcement for sobriety.

For the most efficacious outcome, elements are customized based on an individual client’s needs. Several studies have shown CRA is effective for achieving abstinence. CRA may be integrated with a variety of other treatment approaches including family therapy and motivational interviewing and utilized for other types of drug abuse.

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More on Community Reinforcement Plus Vouchers

The goal of a community-reinforcement approach (CRA) for alcoholism is to achieve abstinence by eliminating positive reinforcement for drinking and enhancing positive reinforcement for sobriety. The underlying philosophy is quite simple – in order to overcome alcohol problems, it is important to rearrange the person’s life so abstinence is more rewarding than drinking. CRA, unlike negative approaches, uses positive incentives to help a client stop drinking instead of punishing the client for failing to stop drinking. In CRA, the client, therapist and significant others work collaboratively to change the alcoholic’s lifestyle through enacting social support systems and healthier activities.

Elements Integral to CRA

Building the client’s motivation to quit drinking: Initially, this process involves identification of positive reinforcements (e.g. praise and shared pleasant events) that might serve as effective incentives for the client to change his or her behavior. The therapist and client create a list of current negative consequences of drinking (e.g. marital or work problems), however, the client is encouraged to devise his or her own patterns of positive change.

Helping the client initiate sobriety: Many clients are reluctant to commit to immediate or complete sobriety. Sobriety sampling uses various counseling strategies to negotiate intermediate goals, for example, a one-month period of sobriety. Research shows allowing a client to set goals regarding a trial period of abstinence results in better outcomes than when a client is given a firm order of abstinence.

Analyzing drinking patterns: This helps identify situations in which drinking is most likely to occur (high-risk situations) as well as past positive consequences of alcohol consumption that potentially reinforced drinking. This step is helpful in determining specific treatment components or modules to tackle a client’s drinking patterns.

Increasing positive reinforcement: Alcoholics often limit their activities and become social loners. An important component of recovery is to reverse the isolation process by spending time with nondrinkers and increasing enjoyable non-drinking-related activities. If a client cannot make a decision what activities to choose, activity sampling encourages trying different activities, or reengaging in activities he or she once found enjoyable.

Learning new coping behaviors: Clients are not told how to change their behaviors. Instead, they practice new coping skills during counseling sessions, especially those involving interpersonal communication.

Involving significant others in the recovery process: Loved ones are coached on how to identify social situations that spark drinking behavior and support behavioral changes in their partners. Moreover, loved ones are taught how to avoid inadvertent reinforcement of drinking (also known as enabling) and increase positive reinforcement for sobriety.

For the most efficacious outcome, elements are customized based on an individual client’s needs. Several studies have shown CRA is effective for achieving abstinence. CRA may be integrated with a variety of other treatment approaches including family therapy and motivational interviewing and utilized for other types of drug abuse.

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